With hospitals facing ongoing financial pressures, including rising costs and declining reimbursement rates, they’re looking for tools that not only improve efficiency — but also increase revenue.
Mercyhealth seems to have found a tool that is accomplishing both feats for its health system.
The system, based in northern Illinois and southern Wisconsin, has six hospitals and 85 primary and specialty care clinics. In 2023, it began using Arintra’s platform, which uses AI to automate coding and identify missed opportunities for reimbursement — and since then, Mercyhealth said it has seen a 5.1% jump in revenue.
Esperion Sets Its Sights on New Areas While Maintaining Commitment to Cardiovascular Health
In a recent interview, Esperion president and CEO, Sheldon Koenig talks about the reality of statin intolerance and his company’s expansion into new diseases
Arintra’s system is designed to accurately code thousands of patient charts without human review.
“It reads unstructured clinical language, interprets the nuance in how different providers document, and applies complex coding logic in real time,” explained Nitesh Shroff, the startup’s CEO.
The platform then converts that information into medical codes and writes them back into the EHR for immediate claim submission.
Mercyhealth has gone live with Arintra’s solution at 37 sites, a combination of clinic and hospital locations. The health system uses the tool across 10 specialties: family medicine, internal medicine, urgent care, pediatrics, cardiology, radiology, gynecology, gastroenterology, endocrinology and hospitalist.
Enhanced Direct Enrollment: Georgia Access and the Power of Partnership
Across the nation, state-based health insurance exchanges are searching for ways to better serve their communities while making enrollment easier, more personal, and more accessible for everyone.
Kelly Pierson, Mercyhealth’s director of coding and clinical documentation integrity, pointed out that Arintra’s platform came out on top after the health system did an “extensive” vendor comparison that looked at capabilities, product roadmaps and implementation requirements.
“Arintra stood out because they took the time to understand how we operate. We have our own business rules, payer-specific requirements, and policies. Arintra configured the platform to match our coding approach. From the start, it felt like a partnership, and that mattered to us,” Pierson stated.
Before adopting Arintra’s platform, Mercyhealth’s coders were able to review only about 30% of charts due to volume constraints, which left the health system vulnerable to coding gaps and missed revenue, she explained.
Arintra now handles the high-volume routine coding. This way, charts are coded more accurately and submitted faster, Pierson said.
“At the same time, with our coders freed up, they can focus on denial analysis and revenue integrity projects. Arintra also helped us provide more targeted education for our providers by identifying documentation gaps, which has allowed us to improve documentation quality over time,” she remarked.
Mercyhealth also cut its days in accounts receivable by roughly 50% after adopting Arintra’s software. Before implementation, the system averaged about 14 days in A/R, and currently, that figure is seven days or fewer, Pierson declared.
She said Mercyhealth’s Arintra deployment shows how automating routine coding can ease pressure on stretched teams while helping health systems protect revenue as reimbursement levers tighten.
Photo: Witthaya Prasongsin, Getty Images